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Renal Cell Carcinoma–Associated Diabetes Mellitus Due to Paraneoplastic Syndrome in Maintenance Hemodialysis: A Case Report

A 59-year-old Japanese woman with a 22-year history of long-term hemodialysis was admitted to our hospital for further examination of hyperglycemia and anemia. Five months before hospitalization, her fasting plasma glucose value was 99 mg/dL and her glycated hemoglobin was 5.7%. On admission, her fa...

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Autores principales: Yoshimura, Yusuke, Suwabe, Tatsuya, Ikuma, Daisuke, Oba, Yuki, Yamanouchi, Masayuki, Sekine, Akinari, Mizuno, Hiroki, Hasegawa, Eiko, Hoshino, Junichi, Kono, Kei, Kinowaki, Keiichi, Ohashi, Kenichi, Sawa, Naoki, Ubara, Yoshifumi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9142673/
https://www.ncbi.nlm.nih.gov/pubmed/35637924
http://dx.doi.org/10.1016/j.xkme.2022.100477
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author Yoshimura, Yusuke
Suwabe, Tatsuya
Ikuma, Daisuke
Oba, Yuki
Yamanouchi, Masayuki
Sekine, Akinari
Mizuno, Hiroki
Hasegawa, Eiko
Hoshino, Junichi
Kono, Kei
Kinowaki, Keiichi
Ohashi, Kenichi
Sawa, Naoki
Ubara, Yoshifumi
author_facet Yoshimura, Yusuke
Suwabe, Tatsuya
Ikuma, Daisuke
Oba, Yuki
Yamanouchi, Masayuki
Sekine, Akinari
Mizuno, Hiroki
Hasegawa, Eiko
Hoshino, Junichi
Kono, Kei
Kinowaki, Keiichi
Ohashi, Kenichi
Sawa, Naoki
Ubara, Yoshifumi
author_sort Yoshimura, Yusuke
collection PubMed
description A 59-year-old Japanese woman with a 22-year history of long-term hemodialysis was admitted to our hospital for further examination of hyperglycemia and anemia. Five months before hospitalization, her fasting plasma glucose value was 99 mg/dL and her glycated hemoglobin was 5.7%. On admission, her fasting plasma glucose value was 873 mg/dL, glycated hemoglobin was 16.2%, C-peptide reactivity was 22.3 ng/mL (reference range, 0.5-3.0), and homeostasis model assessment of insulin resistance (HOMA-IR) was 10.6 (reference range, <2.0); the high HOMA-IR indicated high insulin resistance. Intensive insulin therapy was started for hyperglycemia, which required more than 40 units/day. Computed tomography showed a hypervascular lesion 2.2 cm in diameter on the right kidney; therefore, right nephrectomy was performed. Complete resection was confirmed, and the lesion was diagnosed as a clear cell type of renal cell carcinoma (RCC). Immediately after nephrectomy, glycemic control normalized and administration of insulin was discontinued. Fourteen days after nephrectomy, the HOMA-IR decreased to 2.96. RCC that develops in patients receiving long-term hemodialysis has been reported to be dialysis-related RCC, but there have been no reports suggesting a relationship between dialysis-related RCC and diabetes. To our knowledge, this is the first report of RCC presenting with the paraneoplastic syndrome of acute-onset diabetes because of insulin resistance.
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spelling pubmed-91426732022-05-29 Renal Cell Carcinoma–Associated Diabetes Mellitus Due to Paraneoplastic Syndrome in Maintenance Hemodialysis: A Case Report Yoshimura, Yusuke Suwabe, Tatsuya Ikuma, Daisuke Oba, Yuki Yamanouchi, Masayuki Sekine, Akinari Mizuno, Hiroki Hasegawa, Eiko Hoshino, Junichi Kono, Kei Kinowaki, Keiichi Ohashi, Kenichi Sawa, Naoki Ubara, Yoshifumi Kidney Med Case Report A 59-year-old Japanese woman with a 22-year history of long-term hemodialysis was admitted to our hospital for further examination of hyperglycemia and anemia. Five months before hospitalization, her fasting plasma glucose value was 99 mg/dL and her glycated hemoglobin was 5.7%. On admission, her fasting plasma glucose value was 873 mg/dL, glycated hemoglobin was 16.2%, C-peptide reactivity was 22.3 ng/mL (reference range, 0.5-3.0), and homeostasis model assessment of insulin resistance (HOMA-IR) was 10.6 (reference range, <2.0); the high HOMA-IR indicated high insulin resistance. Intensive insulin therapy was started for hyperglycemia, which required more than 40 units/day. Computed tomography showed a hypervascular lesion 2.2 cm in diameter on the right kidney; therefore, right nephrectomy was performed. Complete resection was confirmed, and the lesion was diagnosed as a clear cell type of renal cell carcinoma (RCC). Immediately after nephrectomy, glycemic control normalized and administration of insulin was discontinued. Fourteen days after nephrectomy, the HOMA-IR decreased to 2.96. RCC that develops in patients receiving long-term hemodialysis has been reported to be dialysis-related RCC, but there have been no reports suggesting a relationship between dialysis-related RCC and diabetes. To our knowledge, this is the first report of RCC presenting with the paraneoplastic syndrome of acute-onset diabetes because of insulin resistance. Elsevier 2022-04-29 /pmc/articles/PMC9142673/ /pubmed/35637924 http://dx.doi.org/10.1016/j.xkme.2022.100477 Text en © 2022 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Yoshimura, Yusuke
Suwabe, Tatsuya
Ikuma, Daisuke
Oba, Yuki
Yamanouchi, Masayuki
Sekine, Akinari
Mizuno, Hiroki
Hasegawa, Eiko
Hoshino, Junichi
Kono, Kei
Kinowaki, Keiichi
Ohashi, Kenichi
Sawa, Naoki
Ubara, Yoshifumi
Renal Cell Carcinoma–Associated Diabetes Mellitus Due to Paraneoplastic Syndrome in Maintenance Hemodialysis: A Case Report
title Renal Cell Carcinoma–Associated Diabetes Mellitus Due to Paraneoplastic Syndrome in Maintenance Hemodialysis: A Case Report
title_full Renal Cell Carcinoma–Associated Diabetes Mellitus Due to Paraneoplastic Syndrome in Maintenance Hemodialysis: A Case Report
title_fullStr Renal Cell Carcinoma–Associated Diabetes Mellitus Due to Paraneoplastic Syndrome in Maintenance Hemodialysis: A Case Report
title_full_unstemmed Renal Cell Carcinoma–Associated Diabetes Mellitus Due to Paraneoplastic Syndrome in Maintenance Hemodialysis: A Case Report
title_short Renal Cell Carcinoma–Associated Diabetes Mellitus Due to Paraneoplastic Syndrome in Maintenance Hemodialysis: A Case Report
title_sort renal cell carcinoma–associated diabetes mellitus due to paraneoplastic syndrome in maintenance hemodialysis: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9142673/
https://www.ncbi.nlm.nih.gov/pubmed/35637924
http://dx.doi.org/10.1016/j.xkme.2022.100477
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